The efficiency of endothelin receptor antagonist bosentan for pulmonary arterial hypertension associated with congenital heart disease: A systematic review and meta-analysis.

Background: Oral bosentan has been widely applied in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A systemic review and meta-analysis was conducted for a therapeutic evaluation of oral bosentan in both adult and pediatric patients with PAH-CHD. The acute respon...

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Publicado en:Medicine Vol. 97; no. 10; pp. 1 - 10
Autores principales: Hong-Yu Kuang, Yu-Hao Wu, Qi-Jian Yi, Jie Tian, Chun Wu, We Nian Shou, Tie-Wei Lu, Kuang, Hong-Yu, Wu, Yu-Hao, Yi, Qi-Jian, Tian, Jie, Wu, Chun, Shou, We Nian, Lu, Tie-Wei
Formato: Journal Article
Publicado: Lippincott Williams & Wilkins Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
      vid: 97
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: The efficiency of endothelin receptor antagonist bosentan for pulmonary arterial hypertension associated with congenital heart disease: A systematic review and meta-analysis.
      aug:
        au:
          Hong-Yu Kuang
          Yu-Hao Wu
          Qi-Jian Yi
          Jie Tian
          Chun Wu
          We Nian Shou
          Tie-Wei Lu
          Kuang, Hong-Yu
          Wu, Yu-Hao
          Yi, Qi-Jian
          Tian, Jie
          Wu, Chun
          Shou, We Nian
          Lu, Tie-Wei
        affil: Department of Cardiology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China.
      sug:
      ab: Background: Oral bosentan has been widely applied in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A systemic review and meta-analysis was conducted for a therapeutic evaluation of oral bosentan in both adult and pediatric patients with PAH-CHD. The acute responses and a long-term effect were respectively assessed in a comparison with baseline characteristics, and the improvement of exercise tolerance was analyzed.Methods: PubMed, Medline, Embase, and Cochrane Central Register of clinical controlled trails or observational studies have been searched for a recording of bosentan effects on the PAH-CHD participants. For mortality and rate of adverse events (AEs), it was described in detail. Randomized-effects model or fixed-effects model was used to calculate different effective values with a sensitivity analysis.Results: Seventeen studies were pooled in this review, and 3 studies enrolled the pediatric patients. Among all studies, 456 patients were diagnosed with PAH-CHD, and 91.7% were treated with oral bosentan. With a term less than 6 months of bosentan therapy, there existed a significant improvement in 6-minute walk distance (6MWD) and the World Health Organization functional class (WHO-FC), but no such differences in Borg dyspnea index scores (BDIs) and the resting oxygen saturation (SpO2). Although with a prolonged treatment, not only 6MWD and FC, but also the resting SpO2 and heart rate were changed for a better exercise capability. Additionally, compared with the basic cardiopulmonary hemodynamics, it showed a statistically significant difference in mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance index (PVRi). Although a limitation of pooled studies with comparative outcomes of different terms, outcomes presented a lower WHO-FC which contributes to a success in a prolonged treatment.Conclusions: Bosentan in PAH-CHD is well established and still requires clinical trials for an identification of its efficiency on CHD patients for an optimized period lessening a serious complication and the common AEs.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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